Expert: Jacqui - 5/2/2008

Question

I'll try and make this brief.  Addicted to hydrocodone for approx. 2.5 yrs.  Before totally flushing my life, family doc referred me to local methadone clinic. Started there one year ago at 30mg daily, up to 100 mg (for one week), then started decreasing slowly. Moved from New England to TN during the process. Now 1 yr. later I'm at 25mg per day, wanting to stop asap, due to cost, pre-employment drug screen, clinic is an hour away (fuel), what are my chances of doing this and still being able to function on a daily basis?  I know the pre-employment thing isn't really a big deal because it is prescribed, but traveling an hour both ways and getting to a new job on time may be an issue.  I've gone 2-3 days without meds previous without issue,(I know it's long-acting) but hear God-awful stories of "never being able to kick methadone"

I've never taken drugs in my life until the hydrocodone for a back injury, then realized how much better my body felt on it rather than off. So, addiction never was an issue until that and now I find myself on one of the hardest drugs to stop taking.  From some of the things I've read, I wish I had never started.  I wish Suboxone was an option, and may be later on when I have more money.

Any thoughts?  

Answer
Hey,

Thanks for your query. I am in Australia and I assume that TN is Tennasee??  (Sorry if I am mistaken).  Anyway, what matters is that you are one hour from your methadone dispenser.  

You are going to feel something, and dependening what you can tolerate, you might be able to do this.  However, in an ideal world, a quick reduction would be done in a supported environment with symptomatic medication, which is difficult while someone is working.  

I assume that there are no closer options and takeaway doses are not available?

Anyway, if I was going to do this quickly, I would drop down 1mg every second day, or if you can manage it, one mg a day.  This obviously will take you 25 days - is this doable?  

I guess one thing to consider is that coming off methadone isn't going to kill you, you are just going to feel lousy.  If there is no chance of you relapsing (ie: you are not going to take heroin or are unlikely to get hydrocodone from a local doctor) then you could go faster, perhaps 3 mg a day.  You will feel bad, but it would be quicker.  

As far as things to make the withdrawal easier, you need to be "kind to yourself".  For example, eat well (even if you don't feel like eating), force yourself to get some exercise, take warm baths as they can help with the muscle pain and speak to your doctor about symptomatic medications (ie: to prevent nausea, diarrhoea, etc).

Good luck!

Jacqui